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His Worship the Mayor, Aldeimen and Councillors of the Metropolitan Borough of Paddington.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present the Annual Report of the Medical Officer of Health for the year 1949.
In this, the first full year following the introduction of the National Health Service, it has been possible to assess
the place of the Health Department in the scheme of things, and to direct our efforts where there appeared to be the
greatest scope for development. The work of the department has been directed towards problems of environmental
hygiene, the supervision of food and food premises, and the control of infectious disease.
Reference to the statistical summary on pages 5 and 6 gives the present position, the birth rate showinga further fall,
but it is still well above the immediate pre.war figure. There has been a slight increase in the death rate, but the
considerable fall in the infant mortality rate is the outstanding feature in the vital statistics this year. In 1901 this
figure was 135 and this year, the fourth successive year in which the figure is the lowest recorded, it is 26. Having
regard to our present knowledge, we are close to what is generally regarded as the irreducible figure for infant deaths.
The tuberculosis figures show little variation and our disappointment at our failure to progress is tempered by the
relief that, in spite of hospital staffing difficulties, the position has not deteriorated.
In the field of environmental hygiene it is gratifying to report that the number of cases requiring legal proceedings
was less than half the number of cases taken in the preceding year.
It is disquieting to note, however, that there is an increasing number of landlords, many of them pensioners relying
on property to supplement their incomes to some extent, who find it very difficult or even impossible to meet the cost of
repairs to property. It is evident that the current high cost of repairs and the small return from rents are factors
which are operating to the detriment of many properties in the Borough. We are faced with the continued deterioration
of many properties with the ultimate prospect of loss of housing accommodation at a time when it is essential to keep
property in a habitable condition if this is possible.
The existing Housing Acts give some powers to local authorities, but our experience suggests that they are inadequate
to deal with many of the problems which are met. It is reasonable to suggest that if local authorities were
relieved of some of the financial risk they might be in a position to undertake further work. In theory expenses may be
recovered in certain cases by the collection of rents, but with controlled rents and present building repair prices it is
doubtful in some cases whether this can be done in a reasonable time with properties requiring extensive repair.
Another aspect of this problem which requires attention is the worn out property with a small return in rent
which cannot be repaired at a reasonable cost. This same property taken over as a derelict building may be almost
completely rebuilt for sale within the Government ceiling figure and give the builder a reasonable profit. So long as
such a state of affairs exists, and this building emergency period may last twenty years, there seems to be a case for
some temporary measure to enable local authorities to deal with such problems themselves. The alternative to
increasing the powers of the local authorities is the unpopular one of increasing the rents. As far as the property owner
with limited means is concerned, one or other of these remedies must be applied and applied soon enough to prevent
the creation of slums faster than we can build new homes.
An unusual occurrence was the notification of two cases of smallpox in the borough. Both cases were infected
on board S.S. Mooltan and one of the cases was fatal. There were no secondary cases. Every possible assistance was
rendered by the epidemiological Medical Officers of the Ministry of Health and the County Council Officers made
vaccination freely available immediately. Details of the outbreak are included in the appropriate section of the
report.
It is a pleasure to record that the Holiday Home for the Aged was opened at Bexhill during the year and that our
hopes for its success have been justified. A description of the home will be found in the report.